STUDY DESIGN.: Case report. OBJECTIVE.: To present a rare case of extramedullary-intradural hemangioblastoma in the thoracic spine and to review the literature on this condition. SUMMARY OF BACKGROUND DATA.: Spinal hemangioblastoma is rare, and moreover, there is seldom purely extramedullary-intradural hemangioblastoma of the spinal cord and there are few reports on histopathological features of spinal hemangioblastoma. METHODS.: A 65-year-old Japanese woman presented with gait disturbance and numbness below the trunk that had gradually worsened, and finally she was unable to walk by herself. Physiologic and neurologic examinations at admission revealed severe transverse neurologic defects, with no sign of von Hippel-Lindau's disease. Radiologic methods showed an extramedullary-intradural mass at Th4-5. A diagnosis of extramedullary-intradural spinal tumor was done, total tumorectomy was performed with recapped laminoplasty. RESULTS.: The patient's neurologic condition gradually improved after the operation. The immunohistopathological findings revealed the diagnosis of hemangioblastoma. CONCLUSION.: A rare case of extramedullary-intradural spinal hemangioblastoma was reported. The immunohistopathological findings were helpful for making a final diagnosis.

In view of the fact that Japanese dietary patterns have been undergoing rapid "Westernization," in part characterized by decrease in fiber, we assessed dietary and crude fiber content in the Japanese diet using food consumption tables for the period from 1911 to 1980, and studied the trend in the reported prevalence of diverticular disease of the colon. Fiber content declined in diphasic pattern: the first decline, which probably had started in the late 19th century, progressed until the Second World War. Although records during the war period were unavailable, the high fiber content of the Japanese diet in the period immediately after the war reflects the tendency to supplement rice with more fiber-rich cereals, and to increase the amount of rice through reduced polishing during the war time. The second decline in fiber content in the Japanese diet, which started in the 1950s and progressed throughout the period of "high economic growth," was mainly due to the decrease in cereal consumption. The changes in crude fiber content in the Japanese diet after the Second World War resemble the pattern of rapid decline noted in the United States during the 1930s to the 1950s. The prevalence of diverticular disease in both countries also shows sudden steep upward turns during the period between 1930 and 1950 in the United States and the late 1970s in Japan, suggesting the presence of threshold level(s) of fiber intake for the effective prevention of diverticular disease. The prevalence of diverticular disease is still relatively low in Japan. However, if the current dietary trend continues, it may rise to a level currently found in the "Western" countries in the coming few decades.

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